For Australia, the growing number of ageing people is a matter of increasing urgency. Australians aged 65 years or more now make up 13% of our society, while those aged 85 years and beyond now account for about 1.5%, and this proportion is rapidly rising. We have a Federal Minister for Ageing, as well as various advisory and advocacy bodies, and there is now greater research focus with the “Ageing Well, Ageing Productively” component of our National Research Priorities.

This focus on ageing reflects concerns not only with the physical and mental decline that are part of ageing, but also with social isolation and the prospect of institutional care. Indeed, some 150 000 elderly Australians live in aged-care facilities. It is reasonable to think that with all the political, professional and consumer interest, all is well with aged care.

Not so!

Attention was recently drawn to abuse, inappropriate and potentially life-threaten-ing polypharmacy and — ironically in this land of plenty — malnutrition, with implications for osteoporosis, fractures, falls and infections. Indeed, one expert recently remarked, “We have older people dying of malnutrition in nursing homes. It happens all the time”. Another labelled this situation a “national shame” and called for more resolute political leadership, eliminating
the bureaucratic merry-go-round.

And herein lies the rub. We endorse inquiries, policy pronouncements and guidelines, but actually do little. The solutions are not rocket science, and include meaningful involvement of dieticians and general practitioners in aged care, education of staff and patients on the importance of nutrition, calorie-dense menus designed by older people themselves, and public dental programs for the aged.

But don’t hold your breath. Pablo Picasso once remarked, “Age only matters when one is ageing”. For most Australians, aged care is out of sight and out of mind. But our time will come.

Martin B Van Der Weyden

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